Aug. 31, 2011 (Paris) -- Heart attack survivors who anger easily or who are often stressed out may be setting themselves up for another, potentially fatal heart attack, a new study suggests.

Over a 10-year period, more than half of heart attack survivors who had high scores on psychological tests designed to identify people with anger problems had a fatal or non-fatal heart attack, compared with fewer than one-fourth of people who had low scores.

"People with a high score on the anger scale were 2.30 times more likely to have [another heart attack] in comparison with those with a low score on the same scale," says researcher Franco Bonaguidi, DPsych, of the Institute of Clinical Physiology in Pisa, Italy.

Similarly, heart attack survivors who scored high on the stress scale were 1.90 times more likely to have another heart attack, compared with those who had low scores, he tells WebMD.

The study involved 228 people who had had a heart attack, 200 of whom were men. Over the 10-year course of the study, 51 people had another heart attack, 28 of whom died.

The findings were presented here at the European Society of Cardiology annual meeting.

Anger a Primitive Emotion

"Anger is a primitive emotion that cannot be switched off at will," Bonaguidi says. "It can have a constructive function when it comes to overcoming obstacles and reach certain objectives."

Beyond a certain point, however, or in people who are already vulnerable to heart disease, "anger can trigger unfavorable physiological changes and can contribute to self-destructive behaviors and food and alcoholic addiction," Bonaguidi says.

The good news: People can change their behavior, he says.

American College of Cardiology Vice President John Harold, MD, a heart specialist at the University of California, Los Angeles, says the findings reflect what he sees in his own practice.

"When a heart attack patient comes in and exhibits anger or turns beet red or is stressed out, I can almost predict [that they are not going to do well] if they don't change their behavior," he tells WebMD.

Harold says he often prescribes an ocean cruise for such patients. His point is relaxation may help their health.

Other advice: If a family argument or other stressful situation is getting out of hand, walk away, Harold says. "It's just not worth it."